IndividualActive
Alicia Pueblo
NPI 1417507344 · Licensed Practical Nurse · Portage, MI
Provider details
- NPI number
- 1417507344
- Entity type
- Individual
- Primary specialty
- Licensed Practical NurseNursing Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 4703114479 (MI)
Specialties & taxonomies
Nursing Service Providers
Practice location
524 W Centre Ave
Portage, MI 49024-5306
Phone: (269) 324-1180
Approximate (ZIP-level) locationGet directions
Mailing address
2404 Hazel Ave
Kalamazoo, MI 49008-2714
Registry dates
- Enumerated
- 2019-09-12
- Last updated
- 2019-09-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.